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milnacipran

Serotonin-Norepinephrine Reuptake Inhibitor · Antidepressant, Anxiolytic

Serotonin-Norepinephrine Reuptake InhibitorAntidepressant, Anxiolytic
CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
—
not curated
Top interactionssee all 12 →
  • AlfentanilSevereDatabaseDDInter
  • AlmotriptanSevereDatabaseDDInter
  • AmitriptylineSevereDatabaseDDInter
  • AmoxapineSevereDatabaseDDInter

Mechanism

Milnacipran inhibits both the neuronal serotonin/5HT transporter (SERT) and the neuronal NE transporter (NET), enhancing both serotonergic and noradrenergic neurotransmission. Initial inhibition of SERT activates 5HT1A and 5HT1D autoreceptors, decreasing transmission until desensitization. Repeated treatment reduces expression of SERT or NET, leading to increased neurotransmitter clearance.

Indications

depressionanxiety disorderspain (off-label)

Drug interactions

Alfentanil
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Almotriptan
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Amitriptyline
Severe
Database

Drug interaction classified as: synergy.

Source: DDInter

Amoxapine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Amphetamine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Benzphetamine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Bupropion
Severe
Database

Drug interaction classified as: synergy.

Source: DDInter

Buspirone
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Citalopram
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Clomipramine
Severe
Database

Drug interaction classified as: synergy

Source: DDInter

Cyclobenzaprine
Severe
Database

.

Source: DDInter

Desipramine
Severe
Database

Clinical effect not specified

Source: DDInter

Related guidelines

Depression in adults
IPS · Psychiatry · 2023
Hypertensive disorders of pregnancy
FOGSI · Obstetrics & Gynaecology · 2019
Alcohol use disorder
MOHFW · Psychiatry · 2021
Schizophrenia
IPS · Psychiatry · 2017
Depression in adults
NICE · Psychiatry · 2022

Other Serotonin-Norepinephrine Reuptake Inhibitor drugs

desvenlafaxine
0 brands
levomilnacipran
0 brands

Ask House about milnacipran

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Sources: Goodman & Gilman 14e·Verified: 2026-05-10 · House clinical team